Special notice: Important policy changes

Mar. 2025Important Notices

Effective May 1, 2025, the following policies will be retired and replaced with prior authorization policies. For more information, please visit upmchp.us/policiesandprocedures.

  • Brachytherapy-MP.220 is being retired and will be replaced by Brachytherapy-MP.PA.139.
  • Implantable Loop Recorder (Subcutaneous) Cardiac Rhythm Monitor – MP.165 is being retired and will be replaced by Implantable Loop Recorder (Subcutaneous) Cardiac Rhythm Monitor – MP.PA.140.

  • Radiation Therapy, External Beam (EBRT) and Intensity-Modulated (IMRT) – MP.034 is being retired and will be replaced with Radiation Therapy, External Beam (EBRT) and Intensity-Modulated (IMRT) – MP.PA.142.

  • Radiation Therapy - SRS and SBRT – MP.060 is being retired and will be replaced with Radiation Therapy - SRS and SBRT – MP.PA.143.

  • Sleep Medicine – Sleep Study – MP.157 is being retired and will be replaced with Sleep Medicine – Sleep Study – MP.PA.144.

Again, prior authorization will be required for all of the new policies beginning May 1.

If you have any questions or concerns about these policy changes, please contact your physician account executive or call Provider Services at 1-866-918-1595.

Thank you for the excellent care and support you provide to our members.

Recent Announcements

CME Webinar: Getting it Right from the Start: Identifying Patient Advanced Care Directives

Please join us for a live, CME-accredited webinar on Thursday, Oct. 15, 2026 that will educate providers on identifying advanced directives and surrogate decision makers on admission.
Oct. 2026Education/Webinars

UPMC Health Plan Tapestry Link live training session

UPMC Health Plan Tapestry Link is scheduled to go live on Tuesday, Dec. 1, 2026. To help prepare you for this launch we will be hosting a live training session on Wednesday, Nov. 4, 2026, from noon to 1 p.m. to help you familiarize yourself with the platform. During this training we will discuss:
Sep. 2026Education/Webinars

Clinical workflow changes through Epic®

Changes are coming for network providers that utilize Provider OnLine to submit specific information to UPMC Health Plan. Select activities that were previously completed in Provider OnLine will now transition to UPMC Health Plan Tapestry Link.
Sep. 2026Important Notices